Long-term consequences of more severe COVID-19 infections in primary care

Abstract

Introduction During the coarse of the pandemic, it became evident that a substantial proportion of COVID-19 patients had persisting symptoms after the acute phase of the infection. Knowledge about the duration of these symptoms in non-hospitalized patients in primary care is essential for the adequacy of their treatment. Methods Patients with a suspected COVID-19 complicated respiratory tract infection between March 1st and June 1st were retrospectively recruited using a query in the general practitioner’s medical files. Due to the limited testing capacity at that time, patients were not aware of their COVID-19 status. The status was then determined using IgG antibody serology and only communicated with the patients after the follow-up period. Participants received a maximum of four questionnaires covering the duration of their symptoms. Data were analyzed using Kaplan Meier survival analysis and COX proportional hazard models adjusted for covariates. Results A total of 291 patients were analyzed. Patients with a positive serology results were on average younger, had more often acute infectious symptoms and had a history of chronic pulmonary disease or smoking less often. Kaplan Meier analysis showed a significantly higher chance of persisting anosmia and ageusia in the serology positive group for all patients and for patients with more severe symptoms. Other Kaplan Meier analyses and the cox proportional hazards models showed no differences in primary and in sensitivity analyses. Conclusion There is no significant difference in the duration of persisting symptoms between patients with a complicated respiratory tract infection in primary care with SARS-CoV-2 IgG antibody negative or positive serology. Anosmia was the only exception. These results plead for a similar societal attitude towards persisting COVID-19 complaints compared to other post-infectious respiratory tract syndromes, but do not reject its existence.